Federal inspection record · CMS data as of October 1, 2026
Madera Rehabilitation & Nursing Center
517 South A Street, Madera, CA · (559) 673-9228
- Certified beds
- 176
- Residents per day
- 169
- Ownership
- For-Profit
- Chain
- Cambridge Healthcare Services
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- January 1, 1967
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in California.
-
Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among California homes
Madera Rehabilitation & Nursing Center carries 259.25 inspection points. That is fewer than 5% of California's 1,154 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in California: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–33 pts
- 4★ 33–66 pts
- 3★ 66–96 pts
- 2★ 96–146 pts
- 1★ over 146 pts
Bars show every rated home in California by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
71 health citations on record since 2019. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (7)
-
G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
G
Provide enough food/fluids to maintain a resident's health.
-
G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
K
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
G
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
-
G
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Everything else, by area of care
Resident Assessment and Care Planning14F
- E
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- F
Ensure services provided by the nursing facility meet professional standards of quality.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Ensure each resident receives an accurate assessment.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- E
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- E
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Ensure each resident receives an accurate assessment.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- E
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Rights12F
- E
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Ensure that residents are fully informed and understand their health status, care and treatments.
- E
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.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
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.
- E
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
- E
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- E
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
- F
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
- E
Reasonably accommodate the needs and preferences of each resident.
- E
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.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Nutrition and Dietary8F
- F
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- F
Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Provide special eating equipment and utensils for residents who need them and appropriate assistance.
- D
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
- D
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Infection Control6F
- E
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- F
Provide and implement an infection prevention and control program.
- F
Provide and implement an infection prevention and control program.
Environmental5E
- E
Keep all essential equipment working safely.
- B
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
- E
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
- E
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
- E
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Administration5F
- F
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
- F
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
- E
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
- E
Have a plan that describes the process for conducting QAPI and QAA activities.
- D
Employ or obtain outside professional resources to provide services in the nursing home when the facility does not employ a qualified professional to furnish a required service.
Pharmacy Service5E
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
- D
Ensure each resident’s drug regimen must be free from unnecessary drugs.
- D
Ensure 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.
- E
Ensure 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.
Freedom from Abuse, Neglect, and Exploitation5D
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Quality of Life and Care2D
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
Nursing and Physician Services2E
- E
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.
- E
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.
Inspection history
2025-08-14
24 health deficiencies · 8 fire-safety deficiencies
Top issue: Nutrition and Dietary (6 deficiencies)
2024-06-21
29 health deficiencies · 14 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (6 deficiencies)
2019-04-26
18 health deficiencies · 7 fire-safety deficiencies
Top issue: Resident Rights (5 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 59 min of nursing staff time a day, 31 min of it from a registered nurse.
This home
3 h 59 min
California average
4 h 33 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 50% of nursing staff and 61% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$373,733 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2025-08-14 | Fine | $126,900 |
| 2025-08-14 | Payment Denial · 15 day denial | $0 |
| 2025-01-09 | Fine | $194,145 |
| 2025-01-09 | Payment Denial · 83 day denial | $0 |
| 2024-03-08 | Fine | $52,688 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days1.3 pts better | 0.9 | 2.2 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.5 pts better | 1.0 | 1.5 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine1.3 pts better | 100.0% | 98.7% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine0.9 pts worse | 97.0% | 97.9% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury2.5 pts worse | 4.1% | 1.6% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms4 pts better | 3.6% | 7.6% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.1 pts worse | 4.2% | 4.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication0.6 pts better | 13.1% | 13.7% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication1.8 pts worse | 14.1% | 12.3% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.3 pts better | 0.0% | 0.3% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened1 pts better | 7.9% | 8.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased4.6 pts better | 5.6% | 10.2% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.5 pts better | 0.2% | 0.7% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.3 pts better | 0.9% | 1.2% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.4 pts worse | 10.2% | 9.8% | 18.3% |
| Percentage of long-stay residents with pressure ulcers3.2 pts better | 1.1% | 4.3% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine2 pts better | 96.6% | 94.6% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit0.8 pts better | 10.3% | 11.1% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.1 pts worse | 1.4% | 1.3% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine0.3 pts better | 93.4% | 93.1% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission2.3 pts better | 20.3% | 22.6% | 23.4% |
·
Who owns and runs it
40 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Crescent Facilities Operations LLC | 5% Or Greater Direct Ownership Interest · Organization | 100% | 8 facilities |
| Win Win Enterprises, LLC | 5% Or Greater Indirect Ownership Interest · Organization | 35% | 28 facilities |
| Jenmax Enterprises LLC | 5% Or Greater Indirect Ownership Interest · Organization | 23% | 9 facilities |
| Jk-Csh Jv LLC | 5% Or Greater Indirect Ownership Interest · Organization | 12% | 8 facilities |
| Manhattan Five Partners LLC | 5% Or Greater Indirect Ownership Interest · Organization | 7% | 11 facilities |
| Bering Properties LLC | 5% Or Greater Indirect Ownership Interest · Organization | 6% | 8 facilities |
| 517 S. A Street LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Bh Alliance | Indirect Ownership Interest · Organization | 0% | 11 facilities |
| Bretsch, Gregory | Managing Control - Governing Body · Individual | 0% | 8 facilities |
| Bretsch, Gregory | Operational/Managerial Control · Individual | 0% | 8 facilities |
| Bretsch, Gregory | Adp Of The SNF · Individual | 0% | 8 facilities |
| Bulosan, Julia | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Bulosan, Julia | Adp Of The SNF · Individual | 0% | 1 facilities |
| Butenko, Julie | Operational/Managerial Control · Individual | 0% | 32 facilities |
| Butenko, Julie | Adp Of The SNF · Individual | 0% | 32 facilities |
| Cambridge Healthcare Services LLC | Operational/Managerial Control · Organization | 0% | 32 facilities |
| Cambridge Healthcare Services LLC | Adp Of The SNF · Organization | 0% | 32 facilities |
| Capela, Heidi | Operational/Managerial Control · Individual | 0% | 32 facilities |
| Capela, Heidi | Adp Of The SNF · Individual | 0% | 32 facilities |
| Hassell, Lance | Operational/Managerial Control · Individual | 0% | 38 facilities |
| Hassell, Lance | Adp Of The SNF · Individual | 0% | 38 facilities |
| Jenmax Enterprises LLC | Adp Of The SNF · Organization | 0% | 9 facilities |
| Jk-Csh Jv LLC | Adp Of The SNF · Organization | 0% | 8 facilities |
| Lal, Akash | Managing Control - Governing Body · Individual | 0% | 1 facilities |
| Lal, Akash | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Lal, Akash | Adp Of The SNF · Individual | 0% | 1 facilities |
| Lutz, Linda | Operational/Managerial Control · Individual | 0% | 31 facilities |
| Lutz, Linda | Adp Of The SNF · Individual | 0% | 31 facilities |
| Salazar, Paulina | Operational/Managerial Control · Individual | 0% | 32 facilities |
| Salazar, Paulina | Adp Of The SNF · Individual | 0% | 32 facilities |
| Singh, Ranjeet | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Singh, Ranjeet | Adp Of The SNF · Individual | 0% | 1 facilities |
| Smedra, Ira | Operational/Managerial Control · Individual | 0% | 31 facilities |
| Smedra, Ira | Adp Of The SNF · Individual | 0% | 31 facilities |
| The Jacob Wintner Trust | Indirect Ownership Interest · Organization | 0% | 8 facilities |
| The Wintner Living Trust Dated 7/08/1992 | Indirect Ownership Interest · Organization | 0% | 12 facilities |
| Win Win Enterprises, LLC | Adp Of The SNF · Organization | 0% | 28 facilities |
| Wintner, Jacob | Corporate Officer · Individual | 0% | 35 facilities |
| Wintner, Jacob | Operational/Managerial Control · Individual | 0% | 35 facilities |
| Wintner, Jacob | Adp Of The SNF · Individual | 0% | 35 facilities |
·
Fire safety
29 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Emergency Preparedness8F
- F
Conduct testing and exercise requirements.
- D
Address subsistence needs for staff and patients.
- D
List the names and contact information of those in the facility.
- D
Establish procedures for tracking staff and patients during an emergency.
- D
List the names and contact information of those in the facility.
- D
Develop and maintain an Emergency Preparedness Program (EP).
- D
Implement emergency and standby power systems.
- D
Conduct risk assessment and an All-Hazards approach.
Smoke6F
- E
Install corridor and hallway doors that block smoke.
- C
Inspect, test, and maintain automatic sprinkler systems.
- F
Provide properly protected cooking facilities.
- F
Properly provide smoke detection systems in areas open to corridors.
- D
Install corridor and hallway doors that block smoke.
- D
Have approved installation, maintenance and testing program for fire alarm systems.
Gas, Vacuum, and Electrical Systems6F
- D
Meet requirements for the use of electrical equipment.
- D
Ensure proper usage of power strips and extension cords.
- D
Ensure precautions for handling oxygen cylinders and equipment are correctly followed.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- F
Ensure proper usage of power strips and extension cords.
- D
Meet requirements for the use of electrical equipment.
Egress3D
- D
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Services2F
- F
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- F
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Construction2D
- D
Use approved construction type or materials.
- D
Use approved construction type or materials.
Miscellaneous2F
- F
Have simulated fire drills held at unexpected times.
- D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
·
Other homes nearby
-
Madera Care Center
Madera, CA · David Johnson
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 4 h 1 min
- Fines
- $34,542
-
Chowchilla Memorial Healthcare District
Chowchilla, CA
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 59 min
- Fines
- $75,499
-
Palms Care Center
Chowchilla, CA · Ajc Healthcare
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 4 h 11 min
- Fines
- $0